Coastal Medical Specialists

Primary specialty

SpecialistTaxonomy code 174400000X

License

049393 Issued in GA

Legal business name

COASTAL MEDICAL SPECIALISTS

Practice address

455 S Main St
Suite 105
Hinesville, GA 31313-4353

Phone

(912) 369-5864

NPI assigned

Feb 15, 2008

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Kimberly Lashawn Davis

Title

Office Manager

Phone

(912) 354-7679

Specialties & licenses 1

Addresses

Other identifiers 6

Other names 1

• COASTAL MEDICAL SPECIALISTS IN LUNG & CRITICAL CARE, PC Other name

Tax ID family

Coastal Med Spec in Lung Cri2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Coastal Medical Specialists in Lung & Critical Care, PC

  • Specialist
  • Savannah, GA
  • NPI 1194949248
  NPD tax ID

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1203033600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1203033600000",
    "number": "1952579666",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3710 WATERS AVE",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314046209",
            "telephone_number": "912-354-7679"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "455 S MAIN ST",
            "address_2": "SUITE 105",
            "city": "HINESVILLE",
            "state": "GA",
            "postal_code": "313134353",
            "telephone_number": "912-369-5864"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COASTAL MEDICAL SPECIALISTS",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-15",
        "last_updated": "2008-02-15",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_middle_name": "LASHAWN",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "912-354-7679"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "GA",
            "license": "049393",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "049393",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00900798E",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00900798D",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00900798C",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00900798F",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00900798G",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "COASTAL MEDICAL SPECIALISTS IN LUNG & CRITICAL CARE, PC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Tierra Clayton
• Hannah Clements, BCBA
• Mary Jennifer Close, NP
• Coastal Health District
• Coastal Medical Arts, LLC
• Coastal Orthopaedics and Sports Medicine Center
• Coastal Pharmacy, Inc.
• Coastal Physicians Alliance, LP
• Shacari Cobb
• Wanda Lea Cochran

• Specialist in Hinesville, GA
• Providers in Hinesville, GA by specialty
• Specialist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.